Cardiovascular disease is the leading cause of death in the US, killing more Americans than cancer and unintentional injuries -- including car crashes, falls and overdoses -- combined.
You've probably heard of heart attacks, strokes and heart failure, but there's a lesser-known, dangerous condition that's often referred to as a "silent killer."
An aortic aneurysm is a bulge of the aorta, the body's largest blood vessel, which carries oxygenated blood from the heart to the rest of the body.
Here are key risk factors for aortic aneurysms and the latest treatment options.
The aorta begins at the heart's base within the left ventricle, then extends upward, forming the aortic arch, before descending through the chest and into the belly.
Broadly speaking, there are two main types of aortic aneurysms.
Thoracic aneurysms generally refer to aneurysms in the chest, while abdominal aneurysms involve the part of the aorta that runs through the belly.
The most common type of aortic aneurysm is the infrarenal, which occurs in the abdominal aorta below the kidneys.
The size of aneurysms varies depending on their location in the body.
For example, in the chest, an aneurysm is when the aortic diameter is greater than 4.5 centimeters.
In the belly, a diameter of over 3 centimeters qualifies as an aneurysm.
While the exact cause of aneurysms is often unknown, there are risk factors associated with the likelihood of developing one.
Age, the male sex, genetics and a bicuspid aortic valve -- a common congenital heart defect where the aortic valve has two cusps instead of three -- are important factors for aneurysms in the chest.
A bicuspid aortic valve occurs in about 1% of the population.
For aneurysms in the abdomen, age and being male are major factors, as well as high blood pressure and smoking.
You can reduce your risk with lifestyle changes such as quitting smoking, controlling blood pressure, following a heart-healthy diet and exercising regularly -- though you should avoid very heavy lifting.
Consider getting screened if you have a family history of aortic aneurysms or if you're a man over 65 who has smoked cigarettes.
Patients referred to our Aortic Center receive an evaluation and a personalized care plan, including genetic testing, advanced imaging and lifestyle recommendations.
People often ask us, "What are the symptoms of an aortic aneurysm?" And the truth is, the majority of patients don't have symptoms.
Aortic aneurysms are considered "silent killers" because most patients don't know they have them.
Fortunately, thanks to modern medical imaging techniques, most patients receive treatment before symptoms occur.
Many patients are referred to our Aortic Center after a test they had done for another reason, such as a cough that didn't go away, palpitations or a murmur, which led to an echocardiogram or a CT scan that uncovered the aneurysm.
When symptoms do occur, they can signal something major, like the aorta is about to rupture or a tear has developed, a serious condition known as an aortic dissection.
If you suddenly experience the worst chest pain of your life, a stabbing sensation radiating from front to back or severe abdominal pain, don't hesitate to call 911. The sooner you get to the hospital for treatment, the better.
We understand that a diagnosis of an aneurysm can be very anxiety-provoking.
The good news is that our multidisciplinary team of experts is here every step of the way, from imaging to lifestyle changes and advice on blood pressure management to surgery if that's required -- and often it's not. Our patients live full and active lives.
Many patients with aortic aneurysms don't need immediate surgery. Aneurysm size and location are significant factors in determining when surgery is necessary.
There are two main ways to treat aortic aneurysms. One is open aortic surgery, where a cut is made to directly access the aorta. Due to the location of aortic root and ascending aortic aneurysm and the desire to preserve the aortic valve, we tend to use open surgical techniques more often to repair aneurysms closer to the heart.
The other involves accessing the femoral artery in the groin. We insert a stent graft, which is basically like relining the inside of the aorta.
Technological advances mean more people can receive stent grafts instead of open surgery. It's generally minimally invasive. Sometimes it's even done when patients are awake. And it helps patients get out of the hospital faster.
Most of our surgical patients are in and out of the hospital within three to four days. They're able to return to their daily routine -- and hopefully live very long and happy lives.
Dr. Geraldine Ong, clinical associate professor in the Department of Medicine, the Leon H. Charney Division of Cardiology at NYU Langone Health and medical director of NYU Langone's Aortic Center, works alongside Dr. Mark Peterson, professor in the Department of Cardiothoracic Surgery, who also serves as system director of aortic surgery for NYU Langone Heart.